Household, family, and child risk factors after an investigation for suspected child maltreatment: A missed opportunity for prevention

Objective: To determine whether a Child Protection Services investigation for suspected child maltreatment is associated with subsequent improvements in household, caregiver, and child risk factors. Design: Retrospective cohort study. Setting: The Longitudinal Studies of Child Abuse and Neglect, a multicenter cohort study of the antecedents and consequences of child maltreatment. Participants: A total of 595 children with the same maternal caregiver responding to Longitudinal Studies of Child Abuse and Neglect surveys at ages 4 and 8 years. Main Exposure: Investigation for suspected child maltreatment between ages 4 and 8 years. Main Outcome Measures: Adjusted differences in 7 modifiable risk factors (social support, family functioning, poverty, maternal education, maternal depressive symptoms, anxious or depressive child behaviors, and aggressive or destructive child behaviors) at age 8 years. Results: Of 595 subjects, 164 (27.6%) experienced an investigation for suspected child maltreatment between ages 4 and 8 years. At age 8 years, investigated subjects were not perceptibly different from noninvestigated subjects in social support, family functioning, poverty, maternal education, or child behavior problems after adjusting for baseline risk factors. Mothers of investigated subjects did have more depressive symptoms than mothers of noninvestigated peers at the child's age of 8 years. Substantiation of child maltreatment by Child Protective Services did not alter these findings. Conclusions: Our finding that an investigation for suspected child maltreatment is not associated with relative improvements in common, modifiable risk factors suggests that we may be missing an opportunity for secondary prevention of maltreatment and maltreatment consequences.